SUMMARY: The objective of this study was to characterize the communication between ulnar and the median nerve in the superficial palmar region from a sample of mestizo-raced population predominant in Latin America. The superficial palmar regions of 53 fresh cadaveric specimens were evaluated, whom of which underwent necropsy procedure at the Institute of Legal Medicine. Dissection was performed by planes until visualizing the presence of the Communicating Branch (CB) between the digital branches of the ulnar nerve (UN) and the median nerve (MN). Qualitative and morphometric evaluation of the CB was carried out. A CB were observed in 82/ 106 (77.4 %) of the cadaveric specimens studied, of which, 38/53 (71.7 %) were bilateral, 15/53 (28.3 %) unilateral; this being a statistically significant difference (p <0.002). Oblique trajectory of the CB between the fourth and third common digital nerve was observed in 70 (85.4 %) specimens, while the CB with transverse trajectory was found in 7 (8.5 %) regions and in a plexiform form in 5 (6.1 %) cases. The length of the CB was 20.2 ± 5.1 mm and the distances from the upper edge of the flexor retinaculum to the proximal and distal points of the CB were 25 ± 6 mm and 37.4 ± 8.3 mm respectively. The anatomical characteristics of the CB patterns, as well as the morphometric CB findings and their points of reference from the carpal flexor retinaculum, make it possible to delimit a safe area of surgical access in the first-fifth proximal of the palmar region, during the surgical approach of carpal tunnel syndrome.

RESUMEN: El objetivo de este estudio fue caracterizar la comunicación entre los nervios ulnar y mediano en la región palmar superficial a partir de una muestra de población de raza mestiza predominante en América Latina. Se evaluaron las regiones palmares superficiales de 53 especímenes cadavéricos frescos, los cuales fueron sometidos procedimiento de necropsia en el Instituto de Medicina Legal. La disección se realizó por planos hasta visualizar la presencia del ramo comunicante (RC) entre los ramos digitales palmares del nervio ulnar (NU) y del nervio mediano (NM). Se realizó evaluación cualitativa y morfométrica del RC, observándose RC en 82/106 (77,4 %) de los especímenes cadavéricos estudiados, de los cuales 38/53 (71,7 %) eran bilaterales, 15/53 (28,3 %) unilaterales; siendo esta una diferencia estadísticamente significativa (p <0,002). Se observó trayectoria oblicua del RC entre el cuarto y tercer nervio digital palmar común en 70 muestras (85,4 %), mientras que el RC con trayectoria transversal se encontró en 7 casos (8,5 %) y en forma plexiforme en 5 casos (6,1 %). La longitud del RC fue de 20,2 ± 5,1 mm y las distancias desde el margen superior del retináculo flexor hasta los puntos proximal y distal del RC fueron de 25 ± 6 mm y 37,4 ± 8,3 mm, respectivamente. Así, los hallazgos morfométricos del RC y sus puntos de referencia, desde el retináculo flexor, permiten delimitar una zona segura de acceso quirúrgico en el primer-quinto proximal de la región palmar, durante el abordaje quirúrgico del síndrome del túnel carpiano.

SUMMARY: The anatomical characteristics of the triceps brachii (TBM) muscle determine the repair speed and torque generation capacity. The TBM is typically innervated by the radial nerve (RN), but there are reports of innervation by the axillary nerve. The aim of this study was to evaluate musculotendinous and nervous components of TBM. Through direct dissection in a sample of 48 arms of the Colombian mestizo population, we evaluated musculotendinous morphometry, nerve branches, motor points (MP) and origin of TBM innervation. The lengths of the medial, lateral and long heads of the TBM corresponded to 77.3 %, 86 % and 97 % of the arm length respectively. The TBM was innervated in the whole sample by the NR who issued between two and five motor branches. The first branch innervated the long head in 100 % of cases and emerged laterally to the tendinous band insertion of the latissimus dorsi muscle. The long head received three MP (26.6 %), located in 85 % of the specimens at 4 - 10 cm of muscular origin; while the lateral head received three MP in 44.4 % of the sample. There were no statistically significant differences between the number of MP of the left TBM in relation to the right (p = 0.578). The dispersion area of MP, as well as TBM morphometry are clinically relevant due to their use in neuromuscular electrical stimulation and nerve transfers. The findings presented in this study are a guide to facilitate results in this type of therapeutic action.

RESUMEN: Las características anatómicas del músculo tríceps braquial (MTB) determinan la velocidad de reparación y capacidad de generación de torque. El MTB es inervado típicamente por el nervio radial (NR), pero existen reportes de inervación por parte del nervio axilar. El propósito de este estudio fue evaluar los componentes musculotendinosos y nerviosos del MTB. Mediante disección directa en una muestra de 48 brazos de población mestiza colombiana, se evaluó morfometría musculotendinosa, ramos nerviosos, puntos motores (PM) y origen de la inervación del MTB. Las longitudes de las cabezas medial, lateral y larga del MTB correspondieron al 77,3 %, 86 % y 97 % respectivamente de la longitud del brazo. El MTB fue inervado en la totalidad de la muestra por el NR quien emitió entre dos y cinco ramos motores. El primer ramo inervó la cabeza larga en el 100 % de los casos y emergió lateral a la banda tendinosa de inserción del músculo latísimo del dorso. La cabeza larga recibió con mayor frecuencia tres PM (26,6 %), ubicados en el 85 % de los especímenes a 4-10 cm del origen muscular; mientras que la cabeza lateral recibió tres PM en el 44,4 % de la muestra. No hubo diferencias estadísticamente significativas entre el número de PM del MTB izquierdo con relación al derecho (p=0,578). El área de dispersión de PM, así como la morfometría del MTB, son de relevancia clínica, debido a su uso en la estimulación eléctrica neuromuscular y transferencias nerviosas. Los resultados presentados en el presente estudio se constituyen en guía que facilita realizar estas acciones terapéuticas.

The intradental length / width ratios have been proposed in more than eleven different models to date. However they have not been studied in the Colombian Mestizo population. Hierarchical clustering models (K-Means) were used to understand which best explains the distribution of the data. Co-variables of sex, age, and mild attrition were also analyzed to assess their influence on overall distribution. Standardized photographs of anterior teeth of 274 individuals of both sexes with fully erupted and healthy teeth were used. Measurements were taken with calibrated software (error of 0.05 mm). Chi square test was used to show that the co-variables sex (p value = 0.09), age (p value = 0.54) and mild attrition (p value = 0.32) had no impact In the distribution of dental proportions. With respect to the analysis of conglomerates through the K-Means, two distinct groups were identified throughout the sample: Vertical proportions (longer teeth) and horizontal proportions (wider teeth). A third group overlapping the two trends we called balanced proportions. There is no universal intraday proportion model that can describe the entire population, but it was possible to find a set of models for different population subgroups. Aesthetic ideals are in open interpretation. Absolute patterns are impractical in biology because they do not predict the complexity of biology.

Las proporciones largo/ancho intradental han sido propuestas en más de once diferentes modelos a la fecha pero no se han estudiando en población mestiza Colombiana. Se utilizaron modelos de agrupamiento jerárquico (K-Means) para entender cual explica mejor la distribución de los datos. También se analizaron co-variables de sexo, edad y atrición leve para evaluar su influencia sobre la distribución general. Fueron utilizadas fotografías estandarizadas de dientes anteriores de 274 individuos de ambos sexos con dientes completamente erupcionados y sanos. Las mediciones fueron realizadas con programas informáticos calibrados (error de 0,05 mm). Se utilizó la prueba Chi Cuadrado para demostrar que las co-variables el sexo (valor de p= 0,09), edad (valor de p= 0,54) y atrición leve (valor de p= 0,32) no tuvieron impacto en la distribución de las proporciones dentales. Con respecto al análisis de conglomerados a través de las K-Means, se identificaron dos grupos diferenciados en toda la muestra: proporciones verticales (dientes mas largos) y proporciones horizontales (dientes mas anchos). Un tercer grupo solapado entre las dos tendencias lo denominamos de proporciones balanceadas. No hay un modelo de proporción intradental universal que pueda describir toda la población, pero fue posible encontrar un conjunto de modelos para los diferentes subgrupos de población. Los ideales estéticos se encuentran en abierta interpretación. Los patrones absolutos son imprácticos en biología ya que no predicen la complejidad de esta.

In spite of its importance as an experimental model, information on therenal artery inpigs is scarce.The objective of this work was to determine the morphological characteristics of the renal artery (RA) and its branches in pigs. One hundred and twenty one (121) pairs of kidneys of pigs destined to slaughter by stunning were studied. The RA and its branches were perfused with polyester resin (Palatal 85 % t Styrene 15 %)and subjected to KOH infusion (potassium hydroxide) for total corrosion. Calibers were measured, and trajectories and relations with adjacent arterial structures were evaluated.Continuous variables were assessed with Student's t test,and discrete variables with Pearson's chi square test. The significance level used was p<0.05. The origin of the RA was symmetric in 57 specimens (50.4 %), with the right renal arterybeing more cranial in 55 % of the cases. Single renal arteries were seen in 98.4 %, without significant side differences (p=0.31).The caliber and length of the RA were 5.11mm (SD1.35) and 30.1mm (SD8.63), respectively. A pattern of RA expression that causes one cranial and one caudal polar branch (Type I) was observed in 97.1 % of the cases. The distribution of the RA in cranial and caudal polar branches was found to be higher than what is described in the literature, since these morphometric features have not been reported in prior studies.These findings contribute to a better knowledge in the field of the compared anatomy of the kidney, and allow for applying the pig model in procedural and hemodynamic applications.

A pesar de su importancia como un modelo experimental, la información sobre la arteria renal en los porcinos es escasa. El objetivo de este trabajo fue determinar las características morfológicas de la arteria renal (AR) y sus ramas en cerdos. Fueron estudiados 121 pares de riñones de cerdos destinados al sacrificio con método de aturdimiento. Las AR y sus ramas fueron perfundidas con resina poliéster (Palatal 85 % t Estireno 15 %) y sometidas a infusión de KOH (hidróxido de potasio) para corrosión total. Se midieron calibres, evaluaron trayectorias y relaciones con estructuras arteriales adyacentes. Se evaluó las variables continuas con el test de t student y las variables discretas con el test de chi cuadrado de Pearson. El nivel de significancia usado fue de p<0,05. El origen de la AR fue simétrico en 57 muestras (50,4 %), siendo la arteria renal derecha la más craneal en el 55 % de los casos. Se observó arterias renales únicas en el 98,4 %, sin diferencias significativas de lado (p=0,31). El calibre y la longitud de la AR fue 5,11 mm (SD 1,35) y 30,1 mm (SD 8,63) respectivamente. En el 97,1 % se observó un patrón de expresión de la AR que origina una rama polar craneal y una caudal (Tipo I). La distribución en ramas polares craneal y caudal de la AR es superior a lo descrito en la literatura, en tanto que las características morfométricas no han sido reportadas en estudios previos. Estos hallazgos contribuyen al mejor conocimiento en el campo de la anatomía comparada del riñón y permiten postular al modelo porcino en aplicaciones procedimentales y hemodinámicas.

We present the case of a left medial gastrocnemius and plantar muscle agenesis in a 58-years old male cadaveric specimen from the Anatomy Laboratory at the Universidad Industrial de Santander (Bucaramanga-Colombia). These unusual muscle absences and associated functional alterations, enrich anatomical knowledge and become important by the time the affected individual may need a reconstructive procedure.

Se presenta un caso de agenesia de los músculos gastrocnemio medial y plantar izquierdos en un espécimen cadavérico masculino de 58 años, del laboratorio de anatomía de la Universidad Industrial de Santander (Bucaramanga- Colombia). Estas raras ausencias musculares enriquecen el conocimiento anatómico con sus alteraciones funcionales concomitantes y permiten postular los posibles procedimientos reconstructivos requeridos en los individuos que las presentan.

Teeth proportions relate to beauty and harmony but aesthetic dental ideal proportion models show inconsistent results. Golden Proportion´s, Preston's, Fayyad's, Snow's, and Ward's models where characterized for best fit in a Colombian mestizo population anterior teeth. Models of teeth´s beauty proportions (Golden Proportion´s, Preston's, Fayyad's, Snow's, and Ward') are analyzed for best fit in a mestizo (mixed race) Colombian population and variables as sex, aesthetic balance or history of previous orthodontic treatments were also analyzed for their probable impact on the distribution of the dental proportions. It was used standardized photographs of anterior teeth on 351 individuals of both sexes with complete erupted and healthy teeth. The measurements were done by calibrated computer software (error of 0.05 mm). A Chi squared test was used to check whether sex, aesthetic balance and previous orthodontic treatment had an impact on the distribution of the dental proportions. Also a nonparametric Wilcoxon test was used to analysis the null hypothesis. A cluster analysis using k means was carried out to search for subgroups, which better explain the distribution of anterior dental proportions in the sample. For the considered results the null hypothesis of the mean equaling to the Golden Proportion was rejected (Wilcoxon test p value <0.001). For the whole population, the Chi squared test did not reject the null hypothesis of equal proportions among the groups with respect to the sex (p value= 0.56), aesthetic balance (p value= 0.98) and history of previous orthodontic treatments (p value= 0.67) variables. For the aesthetically balanced individuals, the Chi squared test also failed to reject the null hypothesis of equal proportions among the groups with respect to the sex (p value= 0.63) and history of previous orthodontic treatments (p value= 0.93) variables. Two Gaussian distributions were found for RED models fitting well in 58 % for RED 70 % (0.7 SD 0.03) and 42 % for RED 75 (0.75 SD 0.025). From the cluster analysis using k means, two groups were identified in the whole sample. No universal model can describe the whole population but is possible to find a set of models for the different population subgroups. Aesthetically ideals are open to interpretation. Clinical aesthetically standards for ideal teeth proportions are open to interpretation in a mestizo (mixed raced) population.

Las proporciones de los dientes se refieren a su belleza y armonía, pero los modelos de proporciones dentales estéticas ideales muestran resultados inconsistentes. La proporción Aurea y los modelos de Preston, Fayyad, Snow, y Ward fueron ajustados para caracterizar los dientes de una población colombiana mestiza. Modelos de proporciones de belleza de dientes (Proporción Aurea, Modelos de Preston, Fayyad, Snow y Ward) se analizaron para lograr alcanzar el mejor ajuste en una población colombiana mestiza (mezcla de razas), y también se analizaron las variables de sexo, equilibrio estético e historia de tratamientos de ortodoncia previos para evaluar su probable impacto sobre la distribución de las proporciones dentales consideradas. Fueron utilizadas fotografías estandarizadas de dientes anteriores de 351 individuos de ambos sexos con dientes completamente erupcionados y sanos. Las mediciones fueron realizadas con programas informáticos calibrados (error de 0,05 mm). Se utilizó la prueba Chi Cuadrado para comprobar si el sexo, el equilibrio estético y el tratamiento ortodóncico previo tuvieron un impacto en la distribución de las proporciones dentales. También se utilizó la prueba no paramétrica de Wilcoxon para el análisis de la hipótesis nula. Un análisis de conglomerados, utilizando la media k, se llevó a cabo para buscar subgrupos, que explicaron mejor la distribución de proporciones dentales anteriores en la muestra. Para que los resultados fueran considerados, la hipótesis nula de la media que equivale a la proporción áurea fue rechazada (Prueba de Wilcoxon, valor p <0,001). Para toda la población, la prueba de Chi Cuadrado no rechazó la hipótesis nula de proporciones iguales entre los grupos con respecto al sexo (valor de p= 0,56), equilibrio estético (valor de p= 0,98) y la historia de tratamientos de ortodoncia previos ( valor de p= 0,67). Para los individuos estéticamente balanceados, la prueba de Chi Cuadrado tampocó rechazó la hipótesis nula de proporciones iguales entre los grupos con respecto a las variables de sexo (valor p= 0,63) y la historia de los tratamientos de ortodoncia anteriores (valor p= 0,93). Se encontraron dos distribuciones gaussianas para los modelos RED que encajaron bien en el 58% para RED 70 % (0,7 DE 0,03) y el 42 % para RED 75 (0,75 DE 0,025). Con respecto al análisis de los conglomerados a través de las medias k, se identificaron dos grupos en toda la muestra. No hay un modelo universal que pueda describir toda la población, pero es posible encontrar un conjunto de modelos para los diferentes subgrupos de población. Los ideales estéticamente están abiertos a interpretación. Las normas clínicas de estética para dientes con proporciones ideales están abiertos a interpretación en una población mestiza.

Introducción: La irrigación palmar ha sido investigada en diferentes grupos poblacionales mediante la disección anatómica directa. Sin embargo, no existe una clasificación estandarizada de arcos palmares superficiales, lo cual conduce a que diferentes autores diseñen clasificaciones propias. Objetivo: Determinar los diferentes patrones del arco palmar superficial y la relevancia tanto clínica como quirúrgica de las diversas variantes anatómicas asociadas a esta estructura. Metodología de búsqueda: Se realizó una búsqueda de literatura en las bases de datos Medline, Ovid, Proquest, Cochrane, SciELO, Lilacs y Hinary, además de textos clásicos de anatomía y cirugía. Se seleccionaron estudios retrospectivos y transversales en especímenes cadavéricos realizados en diferentes grupos poblacionales entre 1987 hasta 2014. Resultados: Se utilizó la clasificación de arco palmar superficial establecida por Lippert y Pabst, que presentó el arco palmar superficial completo como el patrón vascular más común, con una prevalencia del 56,7%, en la que el subtipo más frecuente fue el radio-ulnar clásico con un 64%. La prevalencia del arco palmar superficial incompleto fue de 48,8%, con un subtipo de patrón ulnar reportado en el 24,7% de las muestras evaluadas. Conclusiones: El adecuado conocimiento de los diferentes patrones de la irrigación palmar es esencial para realizar abordajes exitosos en cirugías de mano y para la comprensión de la fisiopatología de enfermedades de carácter laboral como el síndrome de martillo hipotenar. MÉD UIS. 2015;28(3):363-9.

Introduction: The palmar irrigation has been the subject of research in different population groups using direct anatomical dissection. However, there is no standardized classification of superficial palmar arches, which leads the different authors to design own classifications. Objective: to determine the different patterns of superficial palmar arch, and the clinical and surgical revelance of the various anatomical variants associated with this structure. Research methodology: A literature search was performed in data bases Medline, Ovid, Proquest, Cochrane, Scielo, Lilacs and Hinary, besides classical texts of anatomy and surgery. Retrospective and cross-sectional studies were selected in cadaveric specimens made in different population groups between 1987 to 2014. Results: It was used the superficial palmar arch classification established by Lippert and Pabst, that presented the complete superficial palmar arch as the most common vascular pattern, with a prevalence of 56.7%, in which was the most common subtype the classic radio-ulnar (64%). The prevalence of incomplete surperficial palmar arch was 48.8%, with a subtype of ulnar pattern reported in 24.7% of the samples tested. Conclusions: Adequate knowledge of the different patterns of palmar Irrigation is essential for successful approaches in hand surgery, and for understanding the pathophysiology of diseases related to employment as hypothenar hammer syndrome. MÉD UIS. 2015;28(3):363-9.

resumo Objetivo: Determinar a frequência e as características da comunicação entre os nervos mus culocutâneo {NMC} e mediano {NM} em uma amostra da população colombiana e avaliar sua implicação clínica. Métodos: Os braços de 53 cadáveres foram avaliados em necropsia no Instituto Nacional de Medicina Forense, em Bucaramanga, Colômbia. As estruturas do compartimento anterior do braço foram dissecadas e caracterizadas em relação à presença de comunicação entre NMC e NM. Resultados: Um ramo comunicante foi encontrado em 21/106 membros superiores {19,8%}, ocorreu bilateralmente em 10 {47,6%} e unilateralmente em 11 {52,4%}, sem diferença signifi cativa em relação ao lado da ocorrência {p = 0,30}. Em 17% dos casos, havia uma comunicação entre NMC-NM na qual o ramo comunicante emergia do NMC após perfurar o músculo coracobraquial {Tipo I}. Em 2,8% dos casos a conexão foi do NM para o NMC {Tipo II}. O comprimento do ramo comunicante foi 57,8 ±33,4 mm. As distâncias entre os pontos pro ximal e distal desse ramo e o processo coracoide foram de 138 ± 39,4 mm e 188 ± 48,3 mm, respectivamente. O ramo comunicante se localizou principalmente no terço médio do braço. Conclusão: A frequência da comunicação entre NMC-NM observada no presente estudo está na média daquela relatada em outros trabalhos. As conexões NMC-NM devem ser levadas em consideração no diagnóstico e no manejo das lesões dos nervos periféricos dos membros superiores.

ABSTRACT OBJECTIVE: To determine the frequency and features of communication between the musculocutaneous nerve (MCN) and median nerve (MN) in a sample of the Colombian population, and assess its clinical implication. METHODS: The arms of 53 cadaver specimens that had been subjected to necropsy at the National Institute of Forensic Medicine, in Bucaramanga, Colombia, were studied. The structures of the anterior compartment of the arm were dissected and characterized regarding the presence of communication between the MCN and MN. RESULTS: A communicating branch was found in 21/106 upper limbs (19.8%), occurring bilaterally in 10 (47.6%) and unilaterally in 11 (52.4%), without significant difference regarding the side of occurrence (p = 0.30). In 17% of the cases, there was MCN-MN communication in which the communicating branch was seen leaving the MCN after piercing the coracobrachialis muscle (Type I). In 2.8%, the connection was from the MN to the MCN (Type II). The length of the communicating branch was 57.8 ± 33.4 mm. The distances from the proximal and distal points of this branch to the coracoid process were 138 ± 39.4 mm and 188 ± 48.3 mm, respectively. The communicating branch was located mostly in the middle third of the arm. CONCLUSIONS: The frequency of MCN-MN communication observed in the present study is in the middle of the range of what was reported in previous studies. MCN-MN connections need to be taken into account in diagnosing and managing peripheral nerve lesions of the upper limbs.

Introdução: Apesar de sua importância como um modelo experimental, a informação sobre a grande veia cardíaca em suínos é esparsa. Objetivo: Determinar as características morfológicas da grande veia cardíaca e suas tributárias em suínos. Métodos: Foram estudados 120 corações extraídos de suínos destinados para o matadouro com método de atordoamento. Este estudo descritivo cross-over avaliou variáveis contínuas com teste T e variáveis discretas com teste χ quadrado de Pearson. O nível de significância P<0,05 foi usado. A grande veia cardíaca e suas tributárias foram perfundidas com resina de poliéster (85% palatal e estireno de 15%) e, em seguida, submetidas à infusão de hidróxido de potássio para remover a gordura subepicardal. Os calibres foram medidos e trajetórias e relações com estruturas arteriais adjacentes foram avaliadas. Resultados: A origem da grande veia cardíaca foi observada no ápice do coração em 91 (76%) espécimes. O trígono arteriovenoso estava presente em 117 (97,5%) espécimes, correspondente à expressão aberta no seu segmento inferior e para a expressão fechada no segmento superior na maioria dos casos (65%). O calibre da grande veia cardíaca no segmento superior do sulco interventricular paraconal foi de 3,73±0,79 mm. Uma anastomose entre a grande veia cardíaca e da veia cardíaca média foi encontrada em 59 (49%) espécimes. Conclusão: As características morfológicas e biométricas da grande veia cardíaca e suas tributárias não haviam sido relatadas em estudos anteriores e, devido à sua semelhança com as do coração humano, nos permite propor o modelo porcino para procedimentos e aplicações hemodinâmicas.

Introduction: In spite of its importance as an experimental model, the information on the great cardiac vein in pigs is sparse. Objective: To determine the morphologic characteristics of the great cardiac vein and its tributaries in pigs. Methods: 120 hearts extracted from pigs destined to the slaughterhouse with stunning method were studied. This descriptive cross-over study evaluated continuous variables with T test and discrete variables with Pearson χ square test. A level of significance P<0.05 was used. The great cardiac vein and its tributaries were perfused with polyester resin (85% Palatal and 15% Styrene) and then subjected to potassium hydroxide infusion to release the subepicardial fat. Calibers were measured, and trajectories and relations with adjacent arterial structures were evaluated. Results: The origin of the great cardiac vein was observed at the heart apex in 91 (76%) hearts. The arterio-venous trigone was present in 117 (97.5%) specimens, corresponding to the open expression in its lower segment and to the closed expression in the upper segment in the majority of the cases (65%). The caliber of the great cardiac vein at the upper segment of the paraconal interventricular sulcus was 3.73±0.79 mm. An anastomosis between the great cardiac vein and the middle cardiac vein was found in 59 (49%) specimens. Conclusion: The morphological and biometric characteristics of the great cardiac vein and its tributaries had not been reported in prior studies, and due to their similitude with those of the human heart, allows us to propose the pig model for procedural and hemodynamic applications.

Changes in height throughout the day after standing are poorly understood, even in morphological sciences. This study evaluated height variations throughout the day in a sample of young Colombian population. Using a stratified random sampling with proportional allocation, diurnal changes in height was evaluated in 55 subjects. Four measurements of size were taken over a day, using a conventional measurer for it. Statistical analysis of the results was performed by testing agreement (ICC). The average age of the subjects tested was 19.5±1.86 years, of which 22 (40%) were male. The average height and weight were 167.1±8.59 cm and 65.8±14.5 Kg respectively. The average loss of height after the day was 9.4±3.12 mm loss in women was 9.72±3.35 mm and 8.95±2.76 mm in men but this difference was not significant (p=0.22). Statistically significant association between weight >78 Kg and height loss in the day >1cm (p=0.18) was not identified. In the range of 06:00 to 10:00 hours came up with the greatest reduction in size, 60%; while from 10:00 to 14:00 hours the decrease was 10% and 30% of 14:0018:00 hours. Height loss observed in this study was just below that reported in the literature. The knowledge of the changes in height throughout the day should be taken in consideration when diagnosing growth pathologies.

Los cambios en la talla corporal a lo largo del día tras la bipedestación son procesos poco conocidos, aun en el escenario de la morfología. Este estudio evaluó la variación de la talla a lo largo del día en una muestra de población joven colombiana. Mediante un muestreo aleatorio estratificado por asignación proporcional se evaluó la variación de la talla corporal a lo largo del día en 55 sujetos jóvenes. Se tomaron cuatro mediciones de talla durante un día, usando para ello un tallímetro convencional. Se realizó análisis estadístico de los resultados mediante pruebas de concordancia (CCI). La edad promedio de los sujetos evaluados fue de 19,5±1,86 años, de los cuales 22 (40%) fueron del sexo masculino. La talla y peso promedio fueron 167,1±8,59 cm y 65,8±14,5 Kg, respectivamente. La pérdida media de altura al final del día fue 9,4±3,12 mm; la pérdida en las mujeres fue de 9,72±3,35 mm y en los hombres 8,95±2,76 mm sin que esa diferencia fuese significativa (p=0,22). No se identificó asociación entre peso mayor a 78 Kg y pérdida de talla en el día mayor a 1 cm (p=0,18). En la franja de 06:0010:00 horas ocurrió la mayor disminución de la talla, el 60%; mientras que de 10:0014:00 horas la disminución fue 10%, y del 30% de 14:0018:00 horas. La pérdida de talla observada en este estudio es ligeramente inferior a lo reportado en estudios previos. El conocimiento de la variación diaria de la talla corporal debe tenerse en cuenta en el planeamiento de los controles de crecimiento infantil.

Introdução: Apesar de sua importância como modelo experimental, a informação sobre a artéria coronária esquerda em suínos é escassa. Objetivo: Determinar as características morfológicas da artéria coronária esquerda em suínos. Métodos: Foram avaliados 158 corações de porcos. A artéria coronária esquerda foram perfundidos com resina sintética após a sua óstios foram cateterizados. Diâmetros e cursos dos leitos vasculares foram medidos com um paquímetro eletrônico (Mitutoyo(r)). Resultados: O diâmetro da artéria coronária esquerda foi 6,98±1,56 mm e seu comprimento era de 3,51±0,99 mm. Verificou-se que acabam bifurcando-se no interior da artéria descendente anterior e da artéria circunflexa em 79 % dos casos, e dividindo-se em três em 21% dos casos, com a presença da artéria diagonal. A artéria interventricular anterior acabou no ápice em 79,7% dos casos, sendo a artéria marginal na face posterior do ventrículo esquerdo em 64% dos casos, esta artéria nunca chegou ao sulco interventricular posterior. Uma anastomose entre os ramos terminais da artéria interventricular anterior e artéria interventricular posterior foi encontrado em 7,6% das amostras. O ramo ântero-superior da artéria interventricular anterior ocorreu em 89,9% dos corações. Um ramo marginal esquerda foi observado em 87,9% dos casos, com diâmetro de 2,25±0,55 mm. Conclusão: Em comparação com os seres humanos, os porcos têm troncos das artérias coronárias esquerdas mais curtos e ramos; até a artéria circunflexa nunca atinge o sulco interventricular posterior. Nossos resultados são úteis para a concepção de hemodinâmica experimental e modelos processuais.

Introduction: In spite of its importance as an experimental model, the information on the left coronary artery in pigs is sparse. Objective: To determine the morphologic features of the left coronary artery in pigs. Methods: We evaluated 158 pig hearts. The left coronary artery was perfused with synthetic resin after their ostia had been catheterized. Diameters and courses of the vascular beds were measured with an electronic caliper (Mitutoyo(r)). Results: The diameter of left coronary artery was 6.98 ± 1.56 mm and its length was 3.51±0.99 mm. It was found to end up by bifurcating itself into the anterior interventricular artery and the circumflex artery in 79% of the cases, and by trifurcating in 21% of the cases, with the presence of the diagonal artery. The anterior interventricular artery ended up at the apex in 79.7% of the cases, and the circumflex artery at the posterior aspect of the left ventricle in 64% of the case, this artery never reached the posterior interventricular sulcus. An anastomosis between the terminal branches of the anterior interventricular artery and the posterior interventricular artery was found in 7.6% of the specimens. The antero-superior branch of the anterior interventricular artery occurred in 89.9% of the hearts. A left marginal branch was observed in 87.9% of the cases with a diameter of 2.25±0.55 mm. Conclusion: Compared with humans, pigs have shorter left coronary artery trunks and branches; even the circumflex artery never reaches the posterior interventricular sulcus. Our findings are useful for the design of experimental hemodynamic and procedural models.

The basilar artery (BA) has a variable expression which is determinant in the etiology of clinical events that compromise the brain stem. The purpose of this study was to determine the morphological expression of BA in a Colombian population sample. We studied 100 brainstems of individuals which underwent an autopsy at the Instituto de Medicina Legal of Bucaramanga. The vertebra basilar system was perfused with synthetic resin and its calibers, paths, levels of origin and end of the BA were evaluated. The BA presented a rectilinear trajectory in 68%, deviation to the right in 12%, sinuous in 10% and deviation to the left in 10%. The total length of the BA was 30.2 mm SD 4.07, its length in relation to the origin of the superior cerebellar artery was 28.1 mm SD 3.84. The proximal and distal caliber of the BA were 3.96 mm SD 0.48 mm and 3.7 mm SD 0.58 respectively. In relation to the origin arteries of the AB, hypoplasia was observed ( 2 mm) of the right vertebral artery in 8% and the left vertebral artery in 11% (P = 0.30). The origin of BA was observed at different spontomedullary groove levels: at level in 43%, above it in 30% and below it in 27% of the cases. The sinuous and diverted paths from the BA observed and the presence of vertebral artery hypoplasia are slightly higher than those reported in previous studies, while its length is at medium range and its caliber is slightly lower than reported in the literature.

La arteria basilar (AB) presenta una expresión variable, la cual es determinante en la etiología de eventos clínicos que comprometen el tallo cerebral. El propósito de este trabajo fue determinar la expresión morfológica de la AB en una muestra de población colombiana. Fueron estudiados 100 tallos cerebrales de individuos a quienes se les practicó autopsia en el Institutode Medicina Legal de Bucaramanga. El sistema vertebro-basilar fue perfundido con resina sintética y evaluado los calibres, trayectorias, niveles de origen y finalización de la AB. La AB presentó trayectoria rectilínea en 68%, desviación a la derecha en 12%, sinuosa en 10% y desviación a la izquierda en 10%. La longitud total de la AB fue 30,2 mm DE 4,07 y la longitud con relación al origen de la arteria Cerebelar superior fue 28,1 mm DE 3,84. Los calibres proximal y distal de la AB fueron 3,96 mm DE 0,48 mm y 3,7 mm DE 0,58 respectivamente. Con relación a las arterias de origen de la AB, se observó hipoplasia ( 2 mm) de la arteria vertebral derecha en el 8% y de la arteria vertebral izquierda en el 11% (P = 0,30). Se observó el origen de la AB a tres niveles del surco pontomedular: a nivel en el 43%, por arriba de este en el 30% y por debajo de este surco en 27% de los casos. Las trayectorias sinuosas y desviadas de la AB observadas y la presencia de hipoplasias de la arteria vertebral son ligeramente superiores a los señalados en estudios previos, mientras que su longitud se ubica en un rango medio y su calibre es ligeramente inferior a lo señalado en la literatura.

Current studies on anatomical variations of the incus in humans from the morphometric register are insufficient. Structural and dimensional characteristics of the incus are registered in 23 samples of Colombian adult mestizo population. Registered measures involved incus body, incudo-maleolar joint, long process, short process and incudo-stapedial joint. Only eight of the thirty-five records taken in this study could be thoroughly compared to other anterior studies, which showed similarities. The total length of the anvil was 6,51 mm (SD 0.32), the length of the long process of the incus was 5.35 mm (SD 0.25), the distance between processes long and short was 6.06 mm (SD 0.35) and the ratio of lengths between both processes was 82.18% (SD 8.9%). In accordance with the studied population we found paired variation in the anatomy of the incus in only three of the records taken, however, we believe that it is a uniform and morphometrically stable bone.

Los estudios actuales sobre variaciones anatómicas del yunque en humanos a partir del registro morfométrico son insuficientes. Las características estructurales y dimensionales del yunque son registradas en 23 muestras de población mestiza adulta Colombiana. Las medidas registradas involucraron el cuerpo, la articulación incudo-maleolar, el proceso largo, el proceso corto y la articulación incudo-estapedial. Solo ocho de los treinta y cinco registros tomados en este estudio pudieron ser comparados concienzudamente con otros estudios anteriores que mostraron similitudes. El largo total del yunque fue de 6,51 mm (DE 0,32), la longitud del proceso largo del yunque fue de 5,35 mm (DE 0,25), la distancia entre proceso largo y corta fue de 6,06 mm (DE 0,35) y la proporción de longitudes entre ambos procesos fue de 82,18% (DE 8,9). Conforme a la población estudiada se encontró variación pareada en la anatomía del yunque en solo tres de los registros tomados, sin embargo, consideramos que es un hueso morfométricamente uniforme y estable.

It is presented a rare case of multiple variations in the upper limbs of a 45 years old male cadaver specimen, ownership of the morphology laboratory of the Universidad Industrial de Santander (Bucaramanga, Colombia). Muscle variations were observed (presence of both additional heads of the biceps brachii and the flexor pollicis longus, agenesis of right palmaris longus), nervous variations (anastomosis between median and musculocutaneous nerve and between ulnar and median at superficial palmar level). Additionally it presented the radial artery origin from upper left segment of the brachial artery. These various morphological expressions determine relevant clinical implications and should be taken into account in the various surgical approaches to the upper limbs.

Se presenta un raro caso de múltiples variaciones en los miembros superiores de un espécimen cadavérico de 45 años de género masculino, del laboratorio de morfología de la Universidad Industrial de Santander (Bucaramanga-Colombia). Se observó variaciones musculares (presencia bilateral de cabezas adicionales del bíceps braquial y del musculo flexor largo del pulgar, agenesia del palmar largo derecho), nerviosas (anastomosis entre mediano y nervio musculocutáneo, y entre ulnar y mediano al nivel palmar superficial). Adicionalmente, presentó el origen de la arteria radial izquierda desde el segmento superior de la braquial. Estas diversas expresiones morfológicas determinan relevantes implicaciones clínicas y deben tenerse en cuenta en los diferentes abordajes quirúrgicos de los miembros superiores.

INTRODUÇÃO: É necessário conhecer a grande variabilidade da artéria coronária direita (ACD), especialmente por suas implicações nos procedimentos cirúrgicos e eventos clínicos. Esta variabilidade está geralmente relacionada à extensão, à quantidade de ramos, à origem e aos territórios irrigados. OBJETIVO: Avaliar por exame direto a expressão morfológica da ACD em sujeitos colombianos. Métodos: As ACD foram medidas em 221 corações frescos pela canalização do óstio da ACD com uma resina de poliéster sintético que foi injetada em seus ramos. RESULTADOS: O calibre do segmento proximal da ACD e ao nível do ângulo agudo do coração foi de 3,42 ± 0,66 mm e 2,9 ± 0,50 mm, respectivamente. A ACD terminou entre a crux cordis e a margem esquerda em 75,6% da amostra. A artéria interventricular posterior (AIP) atingiu o terço inferior, o ápice ou o sulco interventricular anterior em 149 (67,4%) casos. A artéria do nó sinoatrial (ANS) surgiu da artéria coronária direita em 134 (60,6%) casos, 77 (34,9%) da artéria circunflexa (ACx) e de ambas em 10 (4,5%) amostras. A artéria diagonal posterior direita (ADPD) foi observada em 38 (17,2%) corações, mas apenas 6% da amostra com uma AIP longa, apresentaram a ADPD (P=0,001). Em corações com dominância direita, a ANS surgiu da ACD em 54,7% e da ACx em 46,3% dos casos (P=0,06). CONCLUSÕES: O calibre da ACD e seus ramos é menor do que o relatado na maioria de estudos anteriores, enquanto que a frequência da ADPD é ligeiramente superior ao relatado na literatura. Cenários clínicos e patológicos por estas variações devem ser levados em conta: procedimentos de hemodinâmica, cirurgia cardíaca e arritmias de doença coronária obstrutiva.

BACKGROUND: It is necessary knowing the large variability of right coronary (RCA) artery specialty for its implications in surgical procedures and clinic events. This variability is usually related to the length, branches quantity, origin and irrigated territories. OBJECTIVE: To evaluate by direct examination the morphologic expression of RCA in Colombian people. METHODS: RCA were measured in 221 fresh hearts by RCA ostium canalization with polyester synthetic resin that was injected in their branches. RESULTS: The caliber of the RCA proximal segment and at the level of the acute angle of the heart was 3.42 ± 0.66 mm and 2.9 ± 0.50 mm, respectively. It ended between crux cordis and the left margin in 75.6% of specimens. Posterior interventricular artery (PIA) reached the inferior third, or the apex, or the anterior interventricular sulcus in 149 (67.4%) cases. Sinoatrial node artery (SNA) originated in the right coronary in 134 (60.6%) cases, 77 (34.9%) from circumflex artery (CxA) and from both in 10 (4.5%). Posterior right diagonal artery (PRDA) was noted in 38 (17.2%) hearts, but only 6% of the sample with long PIA, concomitantly presented the PRDA (P = 0.001). In right dominance SNA were originated from RCA in 54.7% and form CxA in 46.3% (P = 0.06). CONCLUSIONS: Caliber of the RCA and its branches is lesser than the majority of previous studies, while the PRDA frequency is slightly higher than the reported in literature. Clinical and pathological scenarios by these variations should be taken into account: hemodynamic procedures, cardiac surgery and arrhythmias from coronary occlusive disease.